Breast cancer risk following Hodgkin lymphoma radiotherapy in relation to menstrual and reproductive factors.
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ICR Authors
Authors
Cooke, R
Jones, ME
Cunningham, D
Falk, SJ
Gilson, D
Hancock, BW
Harris, SJ
Horwich, A
Hoskin, PJ
Illidge, T
Linch, DC
Lister, TA
Lucraft, HH
Radford, JA
Stevens, AM
Syndikus, I
Williams, MV
England and Wales Hodgkin Lymphoma Follow-up Group,
Swerdlow, AJ
Jones, ME
Cunningham, D
Falk, SJ
Gilson, D
Hancock, BW
Harris, SJ
Horwich, A
Hoskin, PJ
Illidge, T
Linch, DC
Lister, TA
Lucraft, HH
Radford, JA
Stevens, AM
Syndikus, I
Williams, MV
England and Wales Hodgkin Lymphoma Follow-up Group,
Swerdlow, AJ
Document Type
Journal Article
Date
2013-06-11
Date Accepted
Abstract
BACKGROUND: Women treated with supradiaphragmatic radiotherapy (sRT) for Hodgkin lymphoma (HL) at young ages have a substantially increased breast cancer risk. Little is known about how menarcheal and reproductive factors modify this risk. METHODS: We examined the effects of menarcheal age, pregnancy, and menopausal age on breast cancer risk following sRT in case-control data from questionnaires completed by 2497 women from a cohort of 5002 treated with sRT for HL at ages <36 during 1956-2003. RESULTS: Two-hundred and sixty women had been diagnosed with breast cancer. Breast cancer risk was significantly increased in patients treated within 6 months of menarche (odds ratio (OR) 5.52, 95% confidence interval (CI) (1.97-15.46)), and increased significantly with proximity of sRT to menarche (Ptrend<0.001). It was greatest when sRT was close to a late menarche, but based on small numbers and needing reexamination elsewhere. Risk was not significantly affected by full-term pregnancies before or after treatment. Risk was significantly reduced by early menopause (OR 0.55, 95% CI (0.35-0.85)), and increased with number of premenopausal years after treatment (Ptrend=0.003). CONCLUSION: In summary, this paper shows for the first time that sRT close to menarche substantially increases breast cancer risk. Careful consideration should be given to follow-up of these women, and to measures that might reduce their future breast cancer risk.
Citation
British journal of cancer, 2013, 108 (11), pp. 2399 - 2406
Source Title
Publisher
NATURE PUBLISHING GROUP
ISSN
0007-0920
eISSN
1532-1827
Research Team
Medicine (RMH Smith Cunningham)
Aetiological Epidemiology
Aetiological Epidemiology